Provider Demographics
NPI:1346780947
Name:PASTEUR PHARMACY V, LLC
Entity Type:Organization
Organization Name:PASTEUR PHARMACY V, LLC
Other - Org Name:PASTEUR MEDICAL WESTCHESTER DISPENSARY
Other - Org Type:Other Name
Authorized Official - Title/Position:PHARMACYQUALITY ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-220-3826
Mailing Address - Street 1:9700 SW 24TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7500
Mailing Address - Country:US
Mailing Address - Phone:305-220-3826
Mailing Address - Fax:305-403-6266
Practice Address - Street 1:9700 SW 24TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7500
Practice Address - Country:US
Practice Address - Phone:305-220-3826
Practice Address - Fax:305-403-6266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
607580332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site